Louisiana
Board of Licensing
BLACKWELL JERRY DALE
Medical
License number
ATH.J00235
Date expires
06/30/2015
Class
Medical
Status
Active
Address
THIBODAUX HIGH SCHOOL, 1355 TIGER DR, THIBODAUX, LA 70301
louisianalicensing.com
ID 21761172
LAST UPDATED 2024-02-19 03:38:23 UTC
LAST UPDATED 2024-02-19 03:38:23 UTC